ArticleJournal of orthopaedic surgery and research2026
Quality of life trajectories following geriatric hip fracture surgery: a growth mixture modelling approach.
Article in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHip fractures remain a serious threat, particularly among the elderly. Characterizing longitudinal patterns of quality of life (QoL) is important to understand recovery after hip fracture. Identifying subgroups with similar trajectories can help design tailored rehabilitation strategies. This study aimed to investigate the trajectories of QoL over one year following hip fracture surgery and to identify factors associated with each trajectory class.
methodsThis longitudinal study utilized a hip fracture registry database from a single medical center. QoL was assessed using the EuroQoL 5-dimension 3-level (EQ-5D-3L) questionnaire at admission, 6 months, and 1 year following hip fracture surgery. Growth mixture modelling was applied to identify subgroups of patients experiencing different trajectories of QoL. Baseline characteristics were compared between groups, and multivariate multinomial logistic regression was used to examine factors associated with trajectory group membership.
resultsThree hundred and eighty-two patients with hip fracture (mean age 80.2; 71.3% female) experienced four distinct QoL trajectories after surgery that were identified: the consistently high QoL group (60.47%) maintained near-optimal QoL throughout follow-up, the partially declined then stable group (21.99%) showed a moderate drop at 6 months with stabilization by 1 year, the notably decreased QoL group (12.83%) demonstrated a steep and persistent decline, representing the poorest recovery, and the recovered Qol group (4.71%) started with the lowest baseline QoL but showed continuous improvement over one year. Multivariate multinomial regression showed that osteosarcopenia, a lower pre-fracture EQ-5D-3L utility score, and poorer activity of daily living predicted a notably decreased QoL trajectory, while older age and worse cognition predicted a partially declined then stable trajectory. No baseline covariates significantly predicted the recovered trajectory.
conclusionFour QoL trajectories within one year following hip fracture surgery in elderly patients were explored. Age, comorbidity burden, musculoskeletal health, cognitive status, baseline QoL, and functional independence were significantly associated with trajectory membership. Routine assessment of these factors can help guide personalized management to help maintain QoL and prevent further decline.
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